Objective To explore the value of serum anti-PLA2R antibody levels in assessing the pathological injury in idio-pathic membranous nephropathy(IMN)by analyzing the correlation between anti-PLA2R antibody levels and pathological injury in IMN.Methods A total of 112 patients with first-time nephrotic syndrome diagnosed as idiopathic membranous nephropathy by renal biopsy were enrolled.Patients were grouped into tertiles based on their serum anti-PLA2R antibody levels.The correla-tion between anti-PLA2R antibody levels and pathological injury degree in IMN was analyzed.Results The positive rate of ser-um anti-PLA2R antibody was 69.64％(78/112).According to the levels of anti-PLA2R antibody,the patients were divided into three groups:Group 1(G1,＜17.05 RU/mL),Group 2(G2,17.05-103.20 RU/mL),and Group 3(G3,＞103.20 RU/mL).The age of patients in G3 was significantly higher than that in G1(P＜0.05).The urine protein-to-creatinine ratio(UPCR)in G3 was significantly higher than that in G1 and G2(P＜0.05),while serum albumin levels were significantly lower in G3 compared to G1(P＜0.05).There were no significant differences in estimated glomerular filtration rate(eGFR)and urine IgG among the three groups(both P＞0.05).The majority of the patients were in pathological stage Ⅱ(70.5％),and the total renal chronicity score(TRCS)grade was predominantly mild,accounting for 74.1％.There was no significant difference between the composition ratio of pathological staging,basement membrane thickness,TRCS grade,or arteriolar sclerosis rates(all P＞0.05).Immunoflu-orescence detection showed that the total positive rate for IgA was 33.9％,with G1 and G2 showing significantly higher IgA positivity rates than G3(P＜0.05).The total IgM positivity rate was 84.8％,and the IgM positivity rate in G1 was higher than that in G3(P＜0.05).The positive rates of C3 and Clq in renal tissue were 98.2％and 44.6％respectively,with no significant difference among the three groups(both P＞0.05).The intensity of IgA and IgM deposit was negatively correlated with serum anti-PLA2R antibody levels(both P＜0.05)and positively correlated with eGFR(both P＜0.05).Conclusion In idiopathic membranous nephropathy,the positive rate of serum anti-PLA2R antibodies is 69.64％.Pathological staging is predominantly stage Ⅱ,and the TRCS grade is mostly mild.Patients with high antibody levels are older than those with low antibody lev-els.The deposition of IgA and IgM in renal tissue may serve as a protective factor for the progression of kidney function.The serum anti-PLA2R antibody level has limited utility in assessing the degree of pathological damage in idiopathic membranous ne-phropathy.
维普
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